| NPI | 1346555984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine (Licence: CO 49865) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: MI 4301095851) |
| Enumeration Date | 2010-08-06 |
| Last Update Date | 2021-12-17 |